| Plastic Surgery Center Of The South | |
|
120 Vann St Ne Suite 150 Marietta GA 30060-7250 | |
| (772) 421-1242 | |
| (770) 424-6652 |
| Full Name | Plastic Surgery Center Of The South |
|---|---|
| Speciality | Clinic/center |
| Location | 120 Vann St Ne, Marietta, Georgia |
| Authorized Official Name and Position | James Edgar Leake (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7704211242 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Plastic Surgery Center Of The South 120 Vann St Ne Suite 150 Marietta GA 30060-7250 Ph: (772) 421-1242 | Plastic Surgery Center Of The South 120 Vann St Ne Suite 150 Marietta GA 30060-7250 Ph: (772) 421-1242 |
| NPI Number | 1295885465 |
|---|---|
| Provider Enumeration Date | 01/11/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295885465 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 261QA1903X (Georgia) | Primary |
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